Self-management support helps carers of people with dementia

Professional self-management support interventions can help the carers of people with dementia cope better. Integrating psycho-education into self-management support may be particularly effective. 

Reviewers from the Netherlands examined interventions to support self-management amongst the carers of people with dementia. They searched five bibliographic databases for systematic reviews available as of March 2014. Ten reviews were included. There was evidence of the effectiveness of professional self-management support interventions targeting psychological wellbeing for reducing stress and improving social outcomes. Interventions providing information were found to increase knowledge. There was limited evidence identified about techniques to cope with memory change on coping skills and mood.

 

Reducing antipsychotic use in people with dementia living in nursing homes

Analysis of research article by Clarissa Giebel for the Mental Elf

Article: Ballard C, et al. (2015) Impact of Antipsychotic Review and Nonpharmacological Intervention on Antipsychotic Use, Neuropsychiatric Symptoms, and Mortality in People With Dementia Living in Nursing Homes: A Factorial Cluster. American Journal of Psychiatry 2015 http://dx.doi.org/10.1176/appi.ajp.2015.15010130

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Image source: NHS PhotoLibrary

‘This is a really substantial randomised controlled trial, that takes into account a complex set of interventions. It is great to see that the trial integrated evidence-based interventions, which were based on existing manuals, such as the Seattle protocol for the exercise intervention. This increases the trial credibility and methodological strength.

As the authors point out, there needs to be a shift away from solely prescribing antipsychotics to using nonpharmacological interventions also, or, in some cases, as an alternative. Hence, it’s recommended that practice guidelines are changed. Indeed, a shift towards nonpharmacological interventions isn’t specific to antipsychotic prescription only. There are many areas in which nonpharmacological interventions can be effective, such as cognition or everyday functioning (Giebel & Challis, 2015). Plus, with the majority of people with dementia being 65 years or older, and most likely already taking several medications, we should be trying to avoid offering more medication wherever possible. Looking at the interventions offered here also, increasing social activities and physical functioning will have additional benefits to the residents’ well-being and cardiovascular functioning.’

Read the full analysis via the Mental Elf

 

Observational cohort study: deprivation and access to anti-dementia drugs in the UK

Cooper, C. et al. Age Ageing (2015). 

Background: UK National Dementia Strategies prioritise fair access to dementia treatments for the whole population. We investigated for the first time inequalities in NHS national dementia prescribing and how they have varied between UK countries and over time.

Method: we investigated the association between Townsend deprivation score and anti-dementia drug prescribing in 77,045 dementia patients from UK primary care records from 2002 to 2013.

Results: we included 77,045 patients with recorded dementia diagnosis or anti-dementia drug prescription. Least deprived patients were 25% more likely to be initiated on anti-dementia drugs than the most deprived (adjusted incidence rate ratio 1.25, 95% confidence interval 1.19–1.31). This was driven by data from English practices where prescribing rates were consistently lower in more deprived patients compared with Scotland, Northern Ireland and Wales, where prescribing was not related to deprivation quintile. Compared with English practices, anti-dementia medication was prescribed more often in Northern Irish (1.81, 1.41–2.34) and less in Welsh practices (0.68, 0.55–0.82), with a trend towards more prescribing in Scottish practices (1.14, 0.98–1.32). Drug initiation rates were also higher in younger people and men.

Conclusion: four years after the English National Dementia Strategy, there is no evidence that the Strategy’s key objective of reducing treatment inequalities is being achieved. Higher overall anti-dementia drug prescribing in Scottish and Northern Irish practices, and differing clinical guidelines in Scotland from other UK countries might explain greater equality in prescribing in these countries. Strategies to offer treatment to more deprived people with dementia in England are needed.

Phenolic Acids, Flavonoids, Champagne Consumption and Dementia Risk Reduction (NHS Choices / Antioxidants and Redox Signaling)

Dementia and Elderly Care News

Summary

Over-interpretation of a recent (2013) piece of animal-based research led some press commentators to insinuate that champagne / white wine consumption might have a role in reducing the risk of dementia in humans. The following NHS ChoicesBehind the Headlines critical appraisal offers a due sense of perspective and reminds readers that it probably won’t.

Full Text Link

Reference

No hard evidence champagne can prevent dementia. London: NHS Choices Behind the Headlines, November 9th 2015.

This relates to:

Full Text Link(Note: This article requires a suitable Athens password, a journal subscription or payment for access).

Reference

Corona, G. Vauzour, D. [and] Hercelin, J. [et al] (2013). Phenolic acid intake, delivered via moderate champagne wine consumption, improves spatial working memory via the modulation of hippocampal and cortical protein expression / activation. Antioxidants and Redox Signaling. November 10th 2013, Vol.19(14), pp.1676-89. (Click here to view the PubMed…

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Dementia research institute

The UK’s first dementia research institute is set to receive up to £150m to tackle the disease.

Led by the Medical Research Council, the institute will bring together world-leading experts, universities and organisations to drive forward research and innovation in fighting dementia. The disease affects an estimated 850,000 in Britain, a figure that’s expected to double in the next 20 years.

The institute will have a central UK hub, with links to universities across the country and will build on the centres of excellence in dementia already operating across the UK.

Can higher educational attainment help lower dementia risk?

Posted by Raluca Lucacel for the Mental Elf

study

We do not know much about the direct causes of dementia, but the evidence for possible causal associations includes (Prince et al., World Alzheimer Report 2015):

  • Low education
  • Hypertension
  • Smoking
  • Diabetes

Knowing the risk factors and acting upon the modifiable ones can lower the incidence of the disease. Our level of education is one of the most accepted risk factors in epidemiological studies for dementia. This factor is a modifiable one, so knowing more about how it influences the disease and acting upon it can lead to lower incidence levels and improved quality of life.

An explorative meta-analysis was conducted in order to find out whether a dose-response relation exists between education and dementia risk (Xu et al, 2015).

This paper presents important modifiable factors for reducing the risk of dementia. Many people consider that everyone gets dementia if they live long enough, but this is not true. Dementia is not a normal part of the ageing process and the more we know about the risk factors of the disease, the more we can do to help prevent it from occurring. – See more at: http://www.nationalelfservice.net/mental-health/dementia/can-higher-educational-attainment-help-lower-dementia-risk/#sthash.o1uC2cDQ.dpuf

via Can higher educational attainment help lower dementia risk?.

Dementia – Immediate Post Diagnosis Support Guidance — London Strategic Clinical Networks

Latest Health News

Released: 17.09.2015 | Dementia

living well with dementia

The living well with dementia workstream has created guidance for professionals to support people with dementia and carers immediately following diagnosis. The guidance covers prognosis, mediations, assessing carers needs, signposting, post diagnosis support, information on services available, and signposts the reader to further information.

This guidance has been produced primarily for professionals working with people with dementia in health and social care settings; however it may also be useful to commissioners.

All support should be tailored to the individual’s needs and wishes in order to provide a personalised approach.Not all information below will be appropriate for everyone and it is the diagnosing clinician’s decision what to discuss. It is unlikely that all topics will be covered in one meeting; it is anticipated that support will be offered over a series of meetings as necessary.

All areas should use these indicators as a guide to ensure that…

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Interventions in supporting self-management of informal caregivers: Systematic Review

Informal caregivers of people with dementia face the challenge of  managing the consequences of dementia in daily life. This meta-review makes an attempt to synthesize evidence from previous systematic reviews about professional self-management support interventions for this group.

Full reference: Huis in het Veld, J et al. The effectiveness of interventions in supporting self-management of informal caregivers of people with dementia; a systematic meta reviewBMC Geriatrics 2015, 15:147